Diet tips for prediabetes

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The Centers for Disease Control and Prevention (CDC) state that people who lose 5–7% of their body weight and perform 150 minutes of exercise per week reduce their risk of developing type 2 diabetes by 58%. This risk reduction percentage is higher in people over 60 years old.

A diet that can help a person lose weight and manage prediabetes typically includes foods that are:

• high in fiber
• low in added sugars
• dense in nutrients

People should eat plenty of:

• vegetables
• whole grains
• lean meats
• legumes
• healthy fats

The body digests whole grain and high-fiber foods slowly, and their sugars enter the bloodstream gradually. This can help people control blood sugar levels and avoid a “crash” that can occur after eating high-sugar foods.

Eating foods high in fiber is also beneficial for:

• weight management
• heart health
• digestive health

Carbohydrates are essential to a balanced diet, but there is no one-size-fits-all amount of carbohydrates a person should eat.

Optimal carbohydrate intake will depend on a person’s health, activity levels, and lifestyle. People with diabetes also need to be mindful of their carbohydrate intake, especially when the carbs come from added sugars.

However, foods that contain carbohydrates and sugar are not always unhealthy. For example, fruits contain natural sugars, and whole grains are high in carbohydrates, but they provide fiber and other nutrients. This makes them suitable, in moderation, for a person who is following a prediabetes diet.

Choose more nonstarchy vegetables

Cutting out carbohydrates is not necessarily healthy. High-carbohydrate foods, such as potatoes and peas, have significant nutritional benefits.

However, many low-carbohydrate foods can provide the same nutrients. Swapping high-carbohydrate foods for lower-carbohydrate options can be beneficial for people with prediabetes.

For example, the following starchy vegetables are high in carbohydrates:

• potatoes
• peas
• corn

The following vegetables have fewer carbohydrates per portion and are rich in fiber and other nutrients:

• asparagus
• broccoli
• carrots
• celery
• green beans
• lettuce and other salad greens
• peppers
• spinach
• tomatoes
• zucchini

The glycemic index (GI) is a list of foods that contain carbohydrates. The ranking shows how quickly these foods raise blood sugar levels. The highest score is 100, and the lowest is 0.

Sample GI values

Exact GI values depend on brands and specific products. Below are the average GI values for 10 common kinds of food and drink.

It is worth keeping in mind that GI values can change from item to item. Some apples, for example, are sweeter than others.

What makes a low or high GI score?

Foods that contain fiber, such as fruits and whole grains, have lower GI scores than those containing refined ingredients.

The body processes sugars and refined carbohydrates quickly. This causes a quick rise in blood sugar levels, or a “sugar spike.” Foods containing refined carbohydrates and added sugars have high GI scores. This is why white bread has a higher GI value than wholemeal bread.

People with prediabetes should try to avoid foods with high GI scores because these raise blood sugar levels quickly. However, the overall amount of carbohydrates a person eats has a greater impact on their blood sugar levels than the specific GI scores of foods.

Some GI tips

The following facts can help guide people looking for low GI options:

• Foods that contain refined sugars typically have higher GI scores than foods that contain natural sugars, such as fruits.
• Whole foods tend to have lower GI scores than products made with refined grains, such as white bread or rice.
• Sweet potatoes, most vegetables, whole fruits, and legumes have lower GI scores than white starchy vegetables, such as potatoes.
• As most fruits and vegetables ripen, their sugar contents increase and their GI scores go up.
• Parboiled rice, basmati rice, and brown rice all have lower GI scores than short-grain or jasmine rice.
• Rolled or steel-cut oats have lower GI scores than quick-cooking oatmeal.

However, researchers have not confirmed whether following a low GI diet helps all people manage prediabetes. It is best to ask a doctor or dietitian for specific advice.

Protein sources such as tofu, lean meats, and low-fat yogurts can help people maintain a balanced diet without adding large amounts of carbohydrates or fats.

Limiting carbohydrate intake can help people to manage their blood sugar levels, while high-fat diets have links to diabetes development.

Healthful protein intake can help people to fill fuller after meals and may even lead to prediabetes remission. However, high-protein diets may increase a person’s risk of cardiovascular diseases, so moderation is key.

Alcohol consumption can increase weight and the risk of diabetes. One study, for example, suggests that “risky” alcohol use significantly raises the chance of developing diabetes in men.

Limiting or avoiding alcohol consumption can help people control their blood glucose levels and lose weight.

People with diabetes who do drink alcohol should avoid sugary mixers, such as sodas.

Reaching and maintaining a moderate weight can help prevent type 2 diabetes from developing. Paying attention to overall calorie intake is a key step.

It can help to limit:

• sugar-sweetened drinks
• foods with high levels of added sugar, such as candy
• foods rich in refined carbohydrates, such as french fries
• red and processed meats

Excessive amounts of saturated fats can also raise cholesterol levels and contribute to the risk of cardiovascular disease.

While limiting the intake of certain foods can reduce a person’s risk of developing diabetes, establishing a balanced diet as part of a healthy lifestyle is the best way to manage prediabetes.

Learn more about the relationship between cholesterol and diabetes here.

People with prediabetes need to keep their blood sugar levels as steady as possible.

Experts recommend eating regular meals throughout the day to avoid fluctuations. They also suggest making sure that meals are balanced, with each containing a source of protein, fat, and carbohydrates.

A person with prediabetes may also find it helpful to eat a consistent amount of carbohydrates at each meal.

The Department of Agriculture has developed this simple way to determine how much of each food type belongs in each meal. Following this method:

• Nonstarchy vegetables take up half the plate.
• Meat, fish, or another protein source takes up just under one-quarter.
• Carbohydrates, such as whole grains, take up just over one-quarter of the plate.
• There is a serving of dairy on the side.

Health authorities, including the National Institutes of Health (NIH), recommend following the Dietary Approaches to Stop Hypertension (DASH) diet. Combined with an awareness of GI scores, it can help people with prediabetes.

This diet focuses not on counting calories but on making healthier choices.

It encourages people to eat:

• vegetables
• fruits
• whole grains
• fat-free or low-fat dairy products
• fish
• poultry
• beans
• nuts
• vegetable oils

It also involves avoiding foods high in saturated fats and sugar, such as:

• fatty meat
• full-fat dairy products
• coconut, palm, and other tropical oils
• candy
• sugary drinks

However, some research indicates that full-fat dairy products, particularly yogurt and cheese, may be beneficial as part of a balanced diet for people with prediabetes.

Numerous studies have found that full-fat dairy products do not have a negative impact on insulin sensitivity or blood pressure and may protect against type 2 diabetes and cardiovascular disease.

Learn more about the DASH diet here.

A person with prediabetes can still enjoy eating in restaurants, but making strategic choices is key.

Here are some tips. A person can:

• aim for quality, such as fresh ingredients, rather than quantity
• see if the menu lists the calories in each dish
• opt for water instead of soda or alcohol

Anyone who has just received a diagnosis of prediabetes may be wondering what they can eat. Here are some suggestions:

To reduce the effects on blood sugar and increase feelings of fullness, a person can try pairing fruit with a source of protein or healthy fat, such as nut butter, a small handful of nuts or seeds, or avocado.

People can check with a doctor or dietitian about how much of each favorite food is appropriate to eat.

Dietary changes alone may not prevent prediabetes from developing into diabetes. Some other strategies involve exercise and medication.

Exercise

Physical activity can help a person lose weight and control their blood sugar levels. Exercise uses up excess blood sugar and can improve insulin sensitivity.

At least one study suggests that making dietary changes and getting more exercise can prevent the progression from prediabetes to diabetes.

For people with type 2 diabetes, the American Diabetes Association recommends getting up every 30 minutes to do some light walking or resistance training during periods of prolonged sitting. This can help reduce blood glucose levels.

Regular activities that may also help include:

• swimming
• brisk walking
• running
• strength training
• flexibility training

Housework, gardening, and other activities can also help.

Medications

For some people with prediabetes, doctors may prescribe metformin to help control blood sugar levels.

In people with obesity and prediabetes, metformin can reduce the risk of developing diabetes by up to 31% over 3 years.

While this figure is hopeful, the NIH states that medications do not appear to be as effective as certain lifestyle changes. It also confirms that metformin can have side effects.

RECALL OF METFORMIN EXTENDED RELEASE

In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.

Prediabetes can develop into diabetes, but making strategic changes to diet and exercise habits can often prevent this, especially if the changes happen early.

There is no one-size-fits-all diet for people with prediabetes. Anyone who receives this diagnosis should ask their doctor, a dietitian, or both for advice.

Read this article in Spanish.